Application value of "diagnostic" transuretbral resection prostate in patients with negative prostate puncture biopsy combined with lower urinary tract symptoms

Objectives To evaluate the value and significance of diagnostic transurethral resection prostate(TURP)on patients with negative prostate puncture biopsy combined with lower urinary tract symptoms. Methods 257 patients over 60 years old from January 2007 to December 2012 were chosen with negative prostate puncture biopsy at first time with elevated PSA level(>4 μg/L), medium and heavy lower urinary tract symptoms(International prostate symptom score(IPSS)> 8.Diagnostic TUEP was used for these patients.According to pathological examination of prostate tissue removed in the surgery, the patients were divided into prostate carcinoma('PCa’)group and benign prostate hypertrophy group.Serum PSA level and international prostate symptom score(IPSS)of patients with benign prostatic hyperplasia(BPH)were observed.Application value of diagnostic TUEP in patients with negative prostate biopsy combined with medium and heavy lower urinary tract symptoms was explored. Results The proportion of all pathological diagnosis accounted for 92%(236/257)by benign prostate hypertrophy, for 8%(21/257)by prostate carcinoma.The age, prostate volume, serum PSA and f/tPSA had no significant difference between the two groups(all P>0.05). We followed BPH patients for 5-8 years.2 patients showed a persistently rising in PSA level and were diagnosed with PCa after 2 times the prostate biopsy.PSA levels and IPSS were significantly decreased and permanently sustained normalization after surgery for the other patients(P<0.05). Conclusions Diagnostic TURP can be used as a helpful method for patients with negative prostate puncture biopsy combined with lower urinary tract symptoms.It achieves the aim of normalizing PSA levels and removing the patient's psychological load. Key words: Diagnose; Prostatectomy; Lower urinary tract symptoms; Prostate-speific antigen